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Q&A Random -16

Q&A Random -16

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Q & A RANDOM \u2013 16
Question Number 1 of 40
The nurse is caring for a client with a hemopneumothorax. The client has a chest tube. The nurse would expect which of
the following color of drainage
A) Red
B) Yellow
C) Clear
D) Brown
Your response was" A". The correct answer is A: Red
"Hemo" implies a bloody pneumothorax, therefore red drainage
Question Number 2 of 40
The nurse is caring for a client with a pneumothorax. The nurse expects the client to have a chest tube inserted because
".

A) It will drain the purulent drainage from the empyema that caused it
B) It is the appropriate post-operative treatment for a pneumothorax
C) It will increase the intrathoracic pressure, restoring it back to normal
D) It will drain air out of the thorax, restoring normal intrathoracic pressure

Your response was" A". The correct answer is D: It will drain air out of the thorax, restoring normal intrathoracic pressure

With a pneumothorax, which is not the result of a surgical procedure, normal intrathoracic pressure increases as a result of the opening in the thorax which allows outside air to rush in and "collapse" the lung; therefore, draining the air out of the thoracic cage reduces that increased intrathoracic pressure and restores it to normal - essentially re-inflating the collapsed lung.

Question Number 3 of 40
A client with a terminal condition is admitted to the nursing unit. The initial action by the nurse would be to

A) Ensure the client is free from pain, nausea, or dyspena
B) refer the client's family to the chaplain
C) discuss the options for advance directions with the client and family
D) collaborate with the multidisciplinary team members

Your response was" A". The correct answer is A: Ensure the client is free from pain, nausea, or dyspena The client should
be kept as comfortable and free from pain, nausea, or dyspnea as possible. After the immediate needs of the client are
met, any of the other choices would be appropriate.

Question Number 4 of 40
A pregnant women is advised to increase her protein and Vitamin C to meet the needs of the growing fetus. Which diet
best meets the client\u2019s needs?

A) Scrambled egg, hash browned potatoes, large nectarine
B) 3oz. chicken, 1/2 C. corn, lettuce salad, small banana
C) 1 C. macaroni, 3/4 C. peas, glass whole milk, medium pear
D) Beef, 1/2 C. lima beans, glass of skim milk, 3/4 C. strawberries

Your response was" A". The correct answer is D: Beef, \u00bd C. lima beans, glass of skim milk, \u00be C. strawberries
Beef and beans are an excellent source of protein as is skim milk. Strawberries are a good source of Vitamin C.
Question Number 5 of 40
The RN is planning the care of a 79-year-old client with skin abrasions from a fall in the home. What aspect of this client's
care is the primary responsibility of the nurse?

A) Identification of a change in skin color
B) Report the finding of any break in the skin
C) Assessment of the integumentary condition

D) Apply lotion to unaffected areas
Your response was" A". The correct answer is C: Assessment of the integumentary condition
The RN is ultimately responsible for thorough, ongoing assessment and evaluation of integument for this client. Because
the nurse is responsible for all care-related decisions, only implementation tasks that do not require independent judgment
can be delegated

Question Number 6 of 40
Which management stylebe s t demonstrates the end of the continuum of management behaviors referred to by Douglas
McGregor as theory Y? The manager

A) is responsible for motivation of employees towars the organizational goals
B) assumes employees are self-motivated and want to work toward organizational and personal goals
C) takes a hands-off attitude and makes no decisions for employees
D) organizes teams of staff and gives compensation to the team rather than individual success

Your response was" A". The correct answer is B: assumes employees are self-motivated and want to work toward
organizational and personal goals McGregor''s theory placed management behaviors on a continuum, with Y being a set
of propositions that describes managers as supporting people who naturally work for organizational and personal goals

Question Number 7 of 40
The nurse, while assessing a 2 day-old newborn, notices that the breasts are enlarged bilaterally with a white, thin
discharge. What action should the nurse do next?

A) Notify the healthcare provider within that shift
B) Ask about medications taken during pregnancy
C) Record the findings while thinking that they are "normal"
D) Obtain fluid to check for glucose by dextrastix

Your response was" A". The correct answer is C: Record the findings as "normal" Newborn infants of both sexes may
have engorged breasts and may secrete milk during the first few days and weeks after birth
Question Number 8 of 40
The nurse is caring for a client with chronic renal failure on hemodialysis 3 times a week. The client becomes confused
and irritable 6 hours before his next treatment. Which of these items might explain the reason for the client\u2019s behavior?
A) Elevated blood urea nitrogen (BUN)
B) Potassium loss
C) Calcium depletion
D) Metabolic alkalosis

Your response was" B". The correct answer is A: Elevated blood urea nitrogen (BUN) Confusion and irritability are signs of
renal encephalopathy secondary to elevated levels of BUN and creatinine in the blood. Other options do not explain the
client\u2019s behavior. Potassium levels are generally high in renal failure. Side effects of calcium depletion manifest as
abdominal and muscle cramping and hyperactive reflexes. Metabolic acidosis not alkalosis is seen in renal failure.

Question Number 9 of 40
The client\u2019s self-esteem ism os t damaged by the nurse\u2019s
A) Anger

B) Indifference C) Disapproval D) Fear

Your response was" A". The correct answer is B: Indifference Positive connectedness/caring objectivity characterizes
therapeutic relationships and is incongruent with indifference
Question Number 10 of 40
A nurse consistently ignores the call lights clients who practice alternative lifestyles. The nurse's behavior is an example of
A) Discrimination
B) Prejudice
C) Stereotyping
D) Cultural insensitivity

Your response was" B". The correct answer is A: Discrimination The differential treatment of individuals because they
belong to a minority group. Generally refers to the limiting of opportunities, choices, or life experiences because of
prejudices about individuals, cultures, or social groups.

Question Number 11 of 40
The nurse is performing a cardiac assessment on a client. The nurse knows that the correct order of blood flow through
the valves of the heart is

A) Tricuspid, pulmonary, mitral, aortic B) Aortic, mitral, tricuspic, pulmonary C) Pulmonary, aortic, mitral, tricuspid D) Mitral, pulmonary, tricuspic, aortic

Your response was" A". The correct answer is A: Tricuspid, pulmonary, mitral, aortic
The correct pathway of blood flow through the valves of the heart is: tricuspid, pulmonary, mitral, aortic.
Question Number 12 of 40
A client has just joined a health care maintenance organization (HMO) and asks for information about the payment
obligations with this plan. Them os t accurate description of health care costs is that the client will be charged

A) Only for services provided by specialists
B) A flat rate for each service rendered
C) A pre-determined fee for all services
D) The usual and customary fee for services

Your response was" B". The correct answer is C: A pre-determined fee for all services An HMO plan is a plan that provides for all services based on a flat rate. During the specified period of enrollment, all health care services are provided with no additional fees.

Question Number 13 of 40
The nurse is caring for a mother who has just delivered a stillborn baby. What would be the most therapeutic comment by
the nurse to this grieving mother?

A) "You are young and will have other children."
B) "Nature has a way of getting rid of the imperfect."
C) "Tell me about your pregnancy experience."
D) "You have an angel in heaven watching over you now."

Your response was" B". The correct answer is C: "Tell me about your pregnancy experience." The nurse must help the
mother actualize the loss by encouraging her to talk about it. Advice and cliches are not comforting
Question Number 14 of 40
Two hours after the normal spontaneous vaginal delivery of a woman, who is gravida 4 para 4, the nurse notes that the
fundus is boggy and displaced slightly above and to the left of the umbilicus. What is the initial nursing action?

A) Assess lochia for color and amount
B) Monitor pulse and blood pressure
C) Call the health care provider immediately
D) Ask the woman to empty her bladder

Your response was" A". The correct answer is D: Ask the woman to empty her bladder A full bladder can displace the
uterus and prevent contraction. After the woman empties the bladder, the fundus should be assessed again.
Question Number 15 of 40
A client is admitted for placement of a suprapubic catheter. Which statement by the client indicates a misunderstanding of
care?

A) "I will change the urine bag as needed."
B) "I will be sure to sit up or move around as much as I can."
C) "I will take the medication to prevent infection only when the urine gets to be cloudy."
D) "I plan to get lots of bottled water since it is easier to have nearby."

Your response was" A". The correct answer is C: "I will take the medication to prevent infection only when the urine gets to
be cloudy."

Prophylactic antibiotics are given continuously. Sitting up enhances the drainage of urine to prevent stasis in the kidney and bladder. Adequate fluid intake will prevent crystallization of the urine and stone formation. Routine changing of the urine bag, as needed is appropriate.

Question Number 16 of 40
The best action to establish correct placement of a gastric tube is for the nurse to

A) aspirate for the color and pH test
B) inject air while listening for the gastric gurgle
C) check the results of the X-ray of tube placement
D) measure the residual volume then reinsert the aspirate

Your response was" A". The correct answer is A: aspirate for the color and pH test All of the options are safe actions.
However checking the color and pH are the best actions for verification of tube placement
Question Number 17 of 40
If the nurse notes cloudy drainage 2 days post insertion of a Tenckhoff catheter for peritoneal dialysis, what other data
does the nurse need to collect before reporting this finding?

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